﻿<!DOCTYPE html>
<html lang="en">
<head>
    <title>数据复核</title>
    <meta charset="UTF-8">
    <!--bootStrop css 单选框样式-->
    <link rel="stylesheet" href="resources/scripts/assets/bootstrap/css/icheck-bootstrap.css">
    <!--bootStrop css 主样式-->
    <link rel="stylesheet" href="resources/scripts/assets/bootstrap/css/bootstrap.min.css">
    <!--jquery js-->
    <script src="resources/scripts/assets/js/jquery-2.2.3.min.js"></script>
    <!--bootStrop js-->
    <script src="resources/scripts/assets/bootstrap/js/bootstrap.min.js"></script>
</head>
<body>
<div id="title"></div>
<div style="width: 95%;background:rgba(149,151,157,0.14);margin:auto">
    <br/>
    <form class="form-inline col-lg-offset-1">
        <div class="col-lg-4 form-group">
            <label>患者:</label>
            <input type="text" class="form-control" id="exampleInputName2" placeholder="患者">
        </div>

        <div class="col-lg-4 form-group">
            <label>数据项:</label>
            <input type="text" class="form-control" id="name" placeholder="数据项">
        </div>

        <div class="col-lg-4 form-group">
            <label for="exampleInputName2">随访组名称:</label>
            <select class="form-control">
                <option>请选择</option>
                <option>随访组1</option>
                <option>随访组2</option>
            </select>
        </div>
        <br/><br/>
        <div class="col-lg-4 form-group">
            <label>质疑者:</label>
            <input type="text" class="form-control" id="phone" placeholder="质疑者">
        </div>
        <div class="col-lg-4 form-group">
            <label>复核者:</label>
            <input type="text" class="form-control" id="email" placeholder="复核者">
        </div>
        <div class="col-lg-4 form-group">
            <label>复核时间:</label>
            <input type="date" class="form-control" id="password" placeholder="密码">
        </div>
        <br/><br/>
        <div class="col-lg-4 form-group">
            <label for="exampleInputName2">表单名称:</label>
            <select class="form-control">
                <option>请选择</option>
                <option>基本信息</option>
                <option>检验检查</option>
            </select>
        </div>
        <div class="col-lg-4 ">
            <label>状态:</label>
            <input type="checkbox" class="btn btn-info">
            <label>待审核</label>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
            <input type="checkbox" class="btn btn-info">
            <label>已修正</label>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
            <input type="checkbox" class="btn btn-info">
            <label>撤回</label>
        </div>
        <div class="col-lg-4">
            &emsp;&emsp;&emsp;&emsp;&emsp;<input type="button" class="btn btn-info" value="检索">
            <input type="reset" class="btn btn-info" value="清空">
        </div>
        <br/><br/><br/>
    </form>
</div>
<br/>
<table class="table table-hover table-bordered" style="width: 95%;text-align: center;margin:auto">
    <tr style="background:rgba(149,151,157,0.14);color: #0e0e0e">
        <td>
            <input type="checkbox"/>
        </td>
        <td>随访组名称</td>
        <td>表单</td>
        <td>数据项</td>
        <td>患者</td>
        <td>值</td>
        <td>质疑者</td>
        <td>复核者</td>
        <td>状态</td>
        <td>复核时间</td>
        <td>复核</td>
    </tr>
    <tr>
        <td>
            <input type="checkbox"/>
        </td>
        <td>随访组1</td>
        <td>基本信息</td>
        <td>身高</td>
        <td>张三</td>
        <td>168</td>
        <td>随访员1</td>
        <td>管理员</td>
        <td>已修正</td>
        <td>2019-11-21</td>
        <td><a href="复核明细.html"><img src="images/单个随访组管理/u167.png"></a></td>
    </tr>
    <tr>
        <td>
            <input type="checkbox"/>
        </td>
        <td>随访组1</td>
        <td>基本信息</td>
        <td>身高</td>
        <td>张三</td>
        <td>168</td>
        <td>随访员1</td>
        <td>管理员</td>
        <td>已修正</td>
        <td>2019-11-21</td>
        <td><a href="复核明细.html"><img src="images/单个随访组管理/u167.png"></a></td>
    </tr>
</table>
<br/>
<div class="">
    <div class="pull-left">
        &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;第1页/共3页&nbsp;&nbsp;&nbsp;&nbsp;总共28条数据
    </div>
    <div class="col-md-offset-9 col-lg-offset-8 col-xs-offset-8 col-sm-offset-8">
        <a href="" style="text-decoration: none">
            <div class="glyphicon glyphicon-step-backward"></div>
            上一页
        </a>
        &nbsp;&nbsp;&nbsp;
        <a href="" style="text-decoration: none">
            下一页
            <div class="glyphicon glyphicon-step-forward"></div>
        </a>
        &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
        <a href="" style="text-decoration: none">
            尾页
            <div class="glyphicon glyphicon-forward"></div>
        </a>
        &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
        跳转到&nbsp;<input type="number" minlength="1" style="width: 10%"/>
        &nbsp;&nbsp;
        <input class="btn btn-info" style="width:12%;height:3%" value="跳转">
    </div>
</div>

</body>
<script>
    $("#title").load("导航条.html");
</script>
</html>